title: Critical care nurses' perception of time spent at rapid responses.
abstract: BACKGROUND
  Critical care nurses are an integral part of rapid response (RR) teams. The length of time they spend away from an intensive care unit (ICU) to attend RRs and how ICU nurses perceive the time away from the ICU has not been previously evaluated.
  
  
  OBJECTIVE
  To determine: (1) the time an ICU nurse spends at RRs; (2) ICU nurses' view of nursing absence; and (3) RR characteristics associated with longer nursing time.
  
  
  METHODS
  A prospective analysis of RRs in one 500-bed adult academic medical center over 1 year. Nurses' perception was assessed through surveys and semistructured interviews.
  
  
  RESULTS
  There were 536 RRs. An ICU nurse was present for 20 minutes or less in 54% of the RRs, 21-40 minutes in 26%, 41-60 minutes in 11%, and more than 60 minutes in 9% of RRs. Compared with nursing time required in RRs for neurologic instability (median [Q1 first quartile {25th percentile}, Q3 third quartile {75th percentile}] = 15.0 [10.0, 27.0] min), nursing time was longer in RRs for hemodynamic instability (30.0 [15.0, 45.0] min) and respiratory failure (25.0 [12.0, 45.0] min; P < 0.0001). Of the 85 nurses surveyed, 47% considered 41-60 minutes as a substantial amount of time at RRs; 99% perceived ICU workload as busier when a nurse attended RRs, and 87% believed ICU care was compromised, defined as reduction in the quality of care.
  
  
  CONCLUSIONS
  In this study of one midsized academic medical center, about half of critical care nurse involvement in RRs takes them away from their ICU patients for less than 20 minutes. Nevertheless, nurses felt that ICU care was compromised when an ICU nurse responded to an RR.
authors.affiliation: The Hofstra North Shore-Long Island Jewish School of Medicine, New Hyde Park, New York, USA. janiceywang@gmail.com
authors.forename: Janice
authors.initials: J
authors.lastname: Wang
authors.forename: Viera
authors.initials: V
authors.lastname: Lakticova
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: McCabe
authors.forename: Bernadette
authors.initials: B
authors.lastname: Amitrano
authors.forename: Lisa
authors.initials: L
authors.lastname: Rosen
authors.forename: Rubin I
authors.initials: RI
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003422:Critical Care; D004630:Emergencies / Q000451:nursing*; D005260:Female; D057209:Hospital Rapid Response Team / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009518:New York; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D013997:Time Factors; D000078329:Workforce; D055815:Young Adult